Análise do Risco de Fadiga no Mar Aplicação da ferramenta Martha a bordo de uma unidade naval

A segurança da navegação e a diminuição dos acidentes marítimos assumem nos dias de hoje um papel de extrema importância a nível internacional, principalmente por parte da indústria marítima, e é na base desta preocupação que surgem organizações como a International Maritime Organization (IMO). Nesta organização, o estudo do fator humano no domínio marítimo tem tido grandes desenvolvimentos, não só através da regulamentação com também da sensibilização dos vários intervenientes. A fadiga no mar, embora seja um tema usual entre os navegantes, nunca houve uma grande sensibilização neste setor. Um tema que envolve a segurança do pessoal e que apenas recentemente foram elaborados estudos relativamente às suas causas, consequências e sobretudo à sua prevenção. É neste sentido que surge o Project Horizon, promovido pela União Europeia, com o objetivo de investigar os padrões de eficácia de alerta dos elementos responsáveis pela condução e manutenção das plataformas marítimas. Como produto final deste projeto europeu surge um protótipo de uma ferramenta de previsão da fadiga. A ferramenta “MARTHA – maritime alertness”, permite relacionar horas de descanso com horas de trabalho, sustentando a análise contínua do risco de fadiga. Este trabalho de investigação, onde é aplicado um protótipo de uma ferramenta para a previsão da fadiga, a bordo de uma unidade naval da Marinha Portuguesa, tem como objetivo a avaliação do risco da fadiga em diferentes regimes horários de bordo. Para este estudo foram elaborados observações de diferentes regimes horários de bordo, por forma a conseguir uma maior variedade de dados e poder analisar comparativamente o rendimento dos respetivos regimes. Esta pesquisa constitui ainda uma medida de sensibilização para a importância da implementação de políticas de gestão da fadiga a bordo das unidades navais.

Sistema de informação para gestão das atividades e suporte à decisão das equipas comerciais

Esta dissertação enquadra-se na área do Customer Relationship Management (CRM), no domínio aplicacional do Sales Force Automation (SFA), em um operador móvel de telecomunicações no suporte à rede comercial. Assim, esta dissertação investiga de que forma a introdução de uma ferramenta SFA em um operador móvel de telecomunicações poderá resolver a enorme dificuldade que a empresa tem em obter informações fiáveis e atempadas. A incapacidade em obter esta informação não permite aos gestores tomar decisões em resposta a alterações súbitas do mercado. Por outro lado, os seus delegados comerciais que suportam os agentes não têm uma ferramenta que organize as suas agendas, e a disponibilização de informação útil e atualizada nas suas visitas aos agentes. Assim, foi decidido investigar qual o impacto resultante da introdução de uma ferramenta SFA, que em tempo real auxilie os gestores na tomada de decisão, na disponibilização de informação que suporte as reuniões dos delegados com os seus agentes, bem como no planeamento e agendamento dessas mesmas reuniões. Foi demonstrada uma relação positiva entre a utilização do SFA e a produtividade dos delegados. Esta alteração de hábitos comportamentais, bem como a disponibilidade de informação permitindo uma melhor monitorização sobre o desempenho dos agentes, afetou positivamente a capacidade de tomada de decisão, tendo provocado um incremento na eficiência das visitas aos agentes, e resultando na melhoria dos indicadores mais importantes da empresa.

Calidad del sueño y rendimiento académico en estudiantes de medicina de la Universidad de Cuenca marzo- agosto 2015

Antecedentes: La mala calidad del sueño en los estudiantes de medicina debido a sus horarios de estudio, turnos, carga académica, estrés emocional y académico, repercute en su salud física y mental. Estudios previos han demostrado la existencia de una relación entre la mala calidad del sueño y un menor rendimiento académico. Objetivo General: Caracterizar la calidad del sueño y su relación con el rendimiento académico en los estudiantes de medicina de la Universidad de Cuenca durante el periodo lectivo Marzo- Agosto 2015. Metodología: Se realizó un estudio transversal a partir de una muestra de 246 estudiantes de medicina seleccionada mediante conglomerados al azar simple. Participaron 244 estudiantes, tras aplicar criterios de exclusión Se utilizó el ICSP para valorar la calidad del sueño y se obtuvo el promedio global de notas del último bimensual. Se buscó relación entre calidad de sueño y rendimiento escolar a través del cálculo de p, OR e IC. Conclusiones: La prevalencia de mala calidad del sueño fue de 66,2%; siendo más frecuente en el sexo femenino (71%). De los estudiantes con un rendimiento académico “Bueno”, el 67% tienen una mala calidad del sueño. Por lo tanto no se encontró una asociación estadísticamente significativa entre la calidad del sueño y el rendimiento académico. Resultados: Se logró obtener una visión general de la prevalencia de la calidad del sueño de los estudiantes de nuestra universidad, y su relación con el rendimiento académico de los mismos. La importancia de este estudio radica en que existen pocos estudios y datos del tema en nuestro país

Climate change and irrigation water requirement at Jaguaribe river basin, semi-arid northeast of Brazil.

Summary: Climate change has a potential to impact rainfall, temperature and air humidity, which have relation to plant evapotranspiration and crop water requirement. The purpose of this research is to assess climate change impacts on irrigation water demand, based on future scenarios derived from the PRECIS (Providing Regional Climates for Impacts Studies), using boundary conditions of the HadCM3 submitted to a dynamic downscaling nested to the Hadley Centre regional circulation model HadRM3P. Monthly time series for average temperature and rainfall were generated for 1961-90 (baseline) and the future (2040). The reference evapotranspiration was estimated using monthly average temperature. Projected climate change impact on irrigation water demand demonstrated to be a result of evapotranspiration and rainfall trend. Impacts were mapped over the target region by using geostatistical methods. An increase of the average crop water needs was estimated to be 18.7% and 22.2% higher for 2040 A2 and B2 scenarios, respectively. Objective ? To analyze the climate change impacts on irrigation water requirements, using downscaling techniques of a climate change model, at the river basin scale. Method: The study area was delimited between 4º39?30? and 5º40?00? South and 37º35?30? and 38º27?00? West. The crop pattern in the target area was characterized, regarding type of irrigated crops, respective areas and cropping schedules, as well as the area and type of irrigation systems adopted. The PRECIS (Providing Regional Climates for Impacts Studies) system (Jones et al., 2004) was used for generating climate predictions for the target area, using the boundary conditions of the Hadley Centre model HadCM3 (Johns et al., 2003). The considered time scale of interest for climate change impacts evaluation was the year of 2040, representing the period of 2025 to 2055. The output data from the climate model was interpolated, considering latitude/longitude, by applying ordinary kriging tools available at a Geographic Information System, in order to produce thematic maps.

GTES: An optimized game-theoretic demand-side management scheme for smart grid

Demand-side management in smart grids has emerged as a hot topic for optimizing energy consumption. In conventional research works, energy consumption is optimized from the perspective of either the users or the power company. In this paper, we investigate how energy consumption may be optimized by taking into consideration the interaction between both parties. We propose a new energy price model as a function of total energy consumption. Also, we propose a new objective function, which optimizes the difference between the value and cost of energy. The power supplier pulls consumers in a round-robin fashion and provides them with energy price parameter and current consumption summary vector. Each user then optimizes his own schedule and reports it to the supplier, which, in turn, updates its energy price parameter before pulling the next consumers. This interaction between the power company and its consumers is modeled through a two-step centralized game, based on which we propose our game-theoretic energy schedule (GTES) method. The objective of our GTES method is to reduce the peak-to-average power ratio by optimizing the users' energy schedules. The performance of the GTES approach is evaluated through computer-based simulations. © 2014 IEEE.

Long-term impact of pneumococcal polysaccharide vaccination on nasopharyngeal carriage in children previously vaccinated with various pneumococcal conjugate vaccine regimes

Previously, the Fiji Pneumococcal Project (FiPP) evaluated reduced dose immunization schedules that incorporated pneumococcal protein conjugate and/or polysaccharide vaccine (PCV7 and 23vPPV, respectively). Immune hyporesponsiveness was observed in children vaccinated with 23vPPV at 12 months of age compared with children who did not receive 23vPPV.

Here we assess the long-term impact of 23vPPV vaccination on nasopharyngeal carriage rates and densities of Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus and Moraxella catarrhalis. Nasopharyngeal swabs (n = 194) were obtained from healthy children who participated in FiPP (now aged 5–7 years). S. pneumoniae were isolated and identified by standard culture-based methods, and serotyped using latex agglutination and the Quellung reaction. Carriage rates and densities of S. pneumoniae, H. influenzae, S. aureus and M. catarrhalis were determined using real-time quantitative PCR.

There were no differences in the rate or density of S. pneumoniae, H. influenzae or M. catarrhalis carriage by PCV7 dose or 23vPPV vaccination in the vaccinated participants overall. However, differences were observed between the two main ethnic groups: Fijian children of Indian descent (Indo-Fijian) were less likely to carry S. pneumoniae, H. influenzae and M. catarrhalis, and there was evidence of a higher carriage rate of S. aureus compared with indigenous Fijian (iTaukei) children. Polysaccharide vaccination appeared to have effects that varied between ethnic groups, with 23vPPV vaccination associated with a higher carriage rate of S. aureus in iTaukei children, while there was a lower carriage rate of S. pneumoniae associated with 23vPPV vaccination in Indo-Fijian children.

Overall, polysaccharide vaccination had no long-term impact on pneumococcal carriage, but may have impacted on S. aureus carriage and have varying effects in ethnic groups, suggesting current WHO vaccine schedule recommendations against the use of 23vPPV in children under two years of age are appropriate.

Managing undesirable outputs in the Australian construction industry using Data Envelopment Analysis models

Carbon reduction has become one of the most significant challenges for economic growth. This paper presents the preliminary analysis of undesirable output reduction targets and emission schedules in temporal-spatial comparisons based on Data Envelopment Analysis. The reduction targets of undesirable outputs are investigated, including the maximum, input, technical and ideal reduction targets. Four Data Envelopment Analysis models that are based on a sequential benchmark technology and variable returns to scale are introduced to measure these reduction percentages. In order to formulate the optimal emission schedule of undesirable outputs, an optimal model is provided without inflation. Data from the Australian construction industry from 2000 to 2010 are employed to develop the models. The results of the analysis indicate that the Australian Government could achieve its promised carbon reduction targets in the construction industry. Most Australian regions' construction industries possess carbon mitigation potential and some of them could increase their desirable outputs if carbon were decreased. This paper suggests that policymakers can benefit from formulating various suitable undesirable output reduction objectives and schedules through the models developed. The research method can be replicated for other sectors and regions focussing on undesirable output reduction.

A novel time computation model based on algorithm complexity for data intensive scientific workflow design and scheduling

Scientific workflow offers a framework for cooperation between remote and shared resources on a grid computing environment (GCE) for scientific discovery. One major function of scientific workflow is to schedule a collection of computational subtasks in well-defined orders for efficient outputs by estimating task duration at runtime. In this paper, we propose a novel time computation model based on algorithm complexity (termed as TCMAC model) for high-level data intensive scientific workflow design. The proposed model schedules the subtasks based on their durations and the complexities of participant algorithms. Characterized by utilization of task duration computation function for time efficiency, the TCMAC model has three features for a full-aspect scientific workflow including both dataflow and control-flow: (1) provides flexible and reusable task duration functions in GCE;(2) facilitates better parallelism in iteration structures for providing more precise task durations;and (3) accommodates dynamic task durations for rescheduling in selective structures of control flow. We will also present theories and examples in scientific workflows to show the efficiency of the TCMAC model, especially for control-flow. Copyright©2009 John Wiley & Sons, Ltd.

The association between anxiety symptoms and sleep in school-aged children: a combined insight from the Children's Sleep Habits Questionnaire and actigraphy

The current study assessed the association between anxiety symptoms and sleep in 90 school-aged children, aged 6-12 years (Mage = 108 months, 52.2% male). The Children's Sleep Habits Questionnaire (CSHQ) and 14 nights of actigraphy were used to assess sleep. Anxiety was assessed using the Spence Children's Anxiety Scale (SCAS). A significant association was found between parent-reported anxiety symptoms and current sleep problems (i.e., CSHQ total scores ≥ 41). An examination of SCAS subscales identified a specific association between generalized anxiety disorder (GAD) symptoms and increased parental sleep concerns, including sleep onset delay, sleep duration, and daytime sleepiness. Regarding actigraphy, whilst anxiety was not associated with average sleep variables, a relationship was identified between anxiety and the night-to-night variability of actigraphy-derived sleep schedules.

In situ synchrotron X-ray diffraction studies of the effect of microstructure on tensile behavior and retained austenite stability of thermo-mechanically processed transformation induced plasticity steel

Transmission electron microscopy and in situ synchrotron high-energy X-ray diffraction were used to investigate the martensitic transformation and lattice strains under uniaxial tensile loading of Fe-Mn-Si-C-Nb-Mo-Al Transformation Induced Plasticity (TRIP) steel subjected to different thermo-mechanical processing schedules. In contrast with most of the diffraction analysis of TRIP steels reported previously, the diffraction peaks from the martensite phase were separated from the peaks of the ferrite-bainite α-matrix. The volume fraction of retained γ-austenite, as well as the lattice strain, were determined from the diffraction patterns recorded during tensile deformation. Although significant austenite to martensite transformation starts around the macroscopic yield stress, some austenite grains had already experienced martensitic transformation. Hooke's Law was used to calculate the phase stress of each phase from their lattice strain. The ferrite-bainite α-matrix was observed to yield earlier than austenite and martensite. The discrepancy between integrated phase stresses and experimental macroscopic stress is about 300 MPa. A small increase in carbon concentration in retained austenite at the early stage of deformation was detected, but with further straining a continuous slight decrease in carbon content occurred, indicating that mechanical stability factors, such as grain size, morphology and orientation of the retained austenite, played an important role during the retained austenite to martensite transformation.

Lateral positioning for critically ill adult patients

BACKGROUND: Critically ill patients require regular body position changes to minimize the adverse effects of bed rest, inactivity and immobilization. However, uncertainty surrounds the effectiveness of lateral positioning for improving pulmonary gas exchange, aiding drainage of tracheobronchial secretions and preventing morbidity. In addition, it is unclear whether the perceived risk levied by respiratory and haemodynamic instability upon turning critically ill patients outweighs the respiratory benefits of side-to-side rotation. Thus, lack of certainty may contribute to variation in positioning practice and equivocal patient outcomes. OBJECTIVES: To evaluate effects of the lateral position compared with other body positions on patient outcomes (mortality, morbidity and clinical adverse events) in critically ill adult patients. (Clinical adverse events include hypoxaemia, hypotension, low oxygen delivery and global indicators of impaired tissue oxygenation.) We examined single use of the lateral position (i.e. on the right or left side) and repeat use of the lateral position (i.e. lateral positioning) within a positioning schedule. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 5), MEDLINE (1950 to 23 May 2015), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1937 to 23 May 2015), the Allied and Complementary Medicine Database (AMED) (1984 to 23 May 2015), Latin American Caribbean Health Sciences Literature (LILACS) (1901 to 23 May 2015), Web of Science (1945 to 23 May 2015), Index to Theses in Great Britain and Ireland (1950 to 23 May 2015), Trove (2009 to 23 May 2015; previously Australasian Digital Theses Program (1997 to December 2008)) and Proquest Dissertations and Theses (2009 to 23 May 2015; previously Proquest Digital Dissertations (1980 to 23 May 2015)). We handsearched the reference lists of potentially relevant reports and two nursing journals. SELECTION CRITERIA: We included randomized and quasi-randomized trials examining effects of lateral positioning in critically ill adults. We included manual or automated turns but limited eligibility to studies that included duration of body position of 10 minutes or longer. We examined each lateral position versus at least one comparator (opposite lateral position and/or another body position) for single therapy effects, and the lateral positioning schedule (repeated lateral turning) versus other positioning schedules for repetitive therapy effects. DATA COLLECTION AND ANALYSIS: We pre-specified methods to be used for data collection, risk of bias assessment and analysis. Two independent review authors carried out each stage of selection and data extraction and settled differences in opinion by consensus, or by third party adjudication when disagreements remained unresolved. We planned analysis of pair-wise comparisons under composite time intervals with the aim of considering recommendations based on meta-analyses of studies with low risk of bias. MAIN RESULTS: We included 24 studies of critically ill adults. No study reported mortality as an outcome of interest. Two randomized controlled trials (RCTs) examined lateral positioning for pulmonary morbidity outcomes but provided insufficient information for meta-analysis. A total of 22 randomized trials examined effects of lateral positioning (four parallel-group and 18 cross-over designs) by measuring various continuous data outcomes commonly used to detect adverse cardiopulmonary events within critical care areas. However, parallel-group studies were not comparable, and cross-over studies provided limited data as the result of unit of analysis errors. Eight studies provided some data; most of these were single studies with small effects that were imprecise. We pooled partial pressure of arterial oxygen (PaO2) as a measure to detect hypoxaemia from two small studies of participants with unilateral lung disease (n = 19). The mean difference (MD) between lateral positions (bad lung down versus good lung down) was approximately 50 mmHg (MD -49.26 mmHg, 95% confidence interval (CI) -67.33 to -31.18; P value < 0.00001). Despite a lower mean PaO2 for bad lung down, hypoxaemia (mean PaO2 < 60 mmHg) was not consistently reported. Furthermore, pooled data had methodological shortcomings with unclear risk of bias. We had similar doubts regarding internal validity for other studies included in the review. AUTHORS' CONCLUSIONS: Review authors could provide no clinical practice recommendations based on the findings of included studies. Available research could not eliminate the uncertainty surrounding benefits and/or risks associated with lateral positioning of critically ill adult patients. Research gaps include the effectiveness of lateral positioning compared with semi recumbent positioning for mechanically ventilated patients, lateral positioning compared with prone positioning for acute respiratory distress syndrome (ARDS) and less frequent changes in body position. We recommend that future research be undertaken to address whether the routine practice of repositioning patients on their side benefits all, some or few critically ill patients.

Low-dose histone deacetylase inhibitor treatment leads to tumor growth arrest and multi-lineage differentiation of malignant rhabdoid tumors

PURPOSE: Malignant rhabdoid tumor (MRT) and atypical teratoid rhabdoid tumors (ATRT) are rare aggressive undifferentiated tumors primarily affecting the kidney and CNS of infants and young children. MRT are almost exclusively characterized by homozygous deletion or inactivation of the chromatin remodeling gene SMARCB1 SMARCB1 protein loss leads to direct impairment of chromatin remodeling and we have previously reported a role for this protein in histone acetylation. This provided the rationale for investigating the therapeutic potential of histone deactylase inhibitors (HDACi) in MRT. EXPERIMENTAL DESIGN: Whereas previously HDACis have been used at doses and schedules that induce cytotoxicity, in the current studies we have tested the hypothesis, both in vitro and in vivo, that sustained treatment of human MRT with low-dose HDACi can lead to sustained cell growth arrest and differentiation. RESULTS: Sustained low-dose panobinostat (LBH589) treatment led to changes in cellular morphology associated with a marked increase in the induction of neural, renal, and osteoblast differentiation pathways. Genome-wide transcriptional profiling highlighted differential gene expression supporting multilineage differentiation. Using mouse xenograft models, sustained low-dose LBH589 treatment caused tumor growth arrest associated with tumor calcification detectable by X-ray imaging. Histological analysis of LBH589-treated tumors revealed significant regions of ossification, confirmed by Alizarin Red staining. Immunohistochemical analysis showed increased TUJ1 and PAX2 staining suggestive of neuronal and renal differentiation, respectively. CONCLUSIONS: Low-dose HDACi treatment can terminally differentiate MRT tumor cells and reduce their ability to self-renew. The use of low-dose HDACi as a novel therapeutic approach warrants further investigation.

Motivating the use of public transit through a mobile glanceable display

With increasing concerns about the impact of global warming on human life, policy makers around the world and researchers have sought for technological solutions that have the potential to attenuate this process. This thesis describes the design and evaluation of an information appliance that aims to increase the use of public transportation. We developed a mobile glanceable display that, being aware of the user’s transportation routines, provides awareness cues about bus arrival time, grounded upon the vision of Ambient Intelligence. We present the design process we followed, from ideation to building a prototype and conducting a field study, and conclude with a set of guidelines for the design of relevant personal information systems. More specifically we seek to test the following hypotheses: 1) That the tangible prototype that provides ambient cues will be used more frequently than a similar purpose mobile app, 2) That the tangible prototype will reduce the waiting time at the bus stop, 3) That the tangible prototype will result to reduced anxiety on passengers, 4) That the tangible prototype will result to an increase in the perceived reliability of the transit service, 5) That the tangible prototype will enhance users’ efficiency in reading the bus schedules and 6) That the tangible prototype will make individuals more likely to use public transit. In a field study, we compare the tangible prototype against the mobile app and a control condition where participants were given no external support in obtaining bus arrival information, other than their existing routines. Using qualitative and quantitative data, we test the aforementioned hypotheses and explore users’ reactions to the prototype we developed.

Qualidade do sono e trabalho por turnos

O estilo de vida, atualmente, tem bastante influência na higiene do sono. São diversos os fatores que contribuem tanto para a sua manutenção como para a sua falha. O trabalho por turnos está frequentemente associado a elevadas cargas de stresse e fadiga devido a situações imprevisíveis e perigosas que possam advir da área profissional, da rotatividade do horário laboral, a um sono deficiente, à falta de atividades desportivas e de lazer, bem como à má alimentação. Estilo de vida, este, que reduz a qualidade de vida em geral e aumenta drasticamente a probabilidade de surgir doenças quer ao nível físico como mental. O sono, por sua vez, é um fenómeno universal de grande importância para o desenvolvimento humano. A qualidade do sono é determinada por vários fatores, entre eles as rotinas de sono. Torna-se, assim, importante estudar as rotinas de forma a incrementar o conhecimento sobre este determinante. A alternância do dia-noite –claro/escuro -, os horários de trabalho, os horários de lazer, as atividades familiares são todos fatores exógenos que sincronizam o ciclo sono-vigília. Estudar a qualidade de sono em profissionais que trabalham por turnos é de extrema relevância visto tratar-se de uma população cada vez mais em risco e em que se considera que o sono seja um dos fatores mais comprometidos. O presente estudo tem como objetivo caraterizar e avaliar a qualidade do sono em profissionais, em função dos horários de trabalho. A metodologia utilizada é quantitativa e centrou-se na aplicação do questionário IQSP – Índice de Qualidade do Sono de Buysse et al. (1989), adaptado e traduzido para português. O questionário foi aplicado a 50 indivíduos pertencentes à Polícia Marítima, na Zona Norte de Portugal Continental, na maioria (92%) homens com idades compreendidas entre os 36 e os 55 anos. Do total de participantes, 76% (n=38) encontra-se a trabalhar por turnos. A análise dos dados foi efetuada através do Statistical Package for the Social Sciences, versão 22, tendo sido realizadas análises descritivas, inferenciais e correlacionais. Com maior relevância, no presente estudo, conclui-se que não existem diferenças estatisticamente significativas na qualidade do sono entre aqueles que trabalham por turnos e os que têm horário fixo, bem como, que a qualidade do sono também não se diferencia em função da idade, do tempo de profissão e da existência de filhos pequenos. Conclui-se, ainda, que a qualidade do sono parece estar relacionada com a satisfação com o horário de trabalho.

Physical activity preferences for people living with multiple myeloma : a qualitative study.

Although physical activity (PA) has significant benefits for people living with multiple myeloma (MM), participation rates are low. Examination of PA preferences will provide important information to clinicians and assist in the development of interventions to increase participation in PA for people living with MM. OBJECTIVE: The aim of this study is to gain an in-depth understanding of the PA preferences for people living with MM, including the preferred role of clinicians. METHODS: Semistructured interviews were conducted with patients treated for MM within the preceding 2 to 12 months. Interviews were analyzed using content analysis, where coding categories were derived directly from the text data. RESULTS: Twenty-four interviews were conducted (women, 54%; age: mean [SD], 62 [8.8] years); 16 (67%) participants had an autologous stem cell transplant. Light- to moderate-intensity PA during and after treatment was feasible, with the strongest preference for a program 2 to 8 months after treatment. The timing of information delivery was important, as was input from clinicians and organizations with knowledge of MM. Preferences for location, structure, and timing of programs varied. CONCLUSIONS: Low- to moderate-intensity PA after treatment is likely to interest people with MM. Programs need to be flexible and consider individual differences in PA preferences, functional status, and treatment schedules. IMPLICATIONS: An individually tailored PA program should form part of clinical care, involving clinicians and organizations with expertise in MM. Options for home-based PA are also important. Further research, including a population-based study of people living with MM, is necessary to further quantify PA preferences.